Shackles off: How care for Minnesota's pregnant inmates is improving

When the law caught up with Raejean Icard, she was several weeks pregnant and terrified of giving birth behind bars.

Fellow inmates at Shakopee women's prison did their best to prepare her to deliver under the gaze of corrections officers. No family members would be allowed in the room and she might be shackled, they warned.

But to Icard's surprise, when she went into labor in May, she was treated like any other new mother at St. Francis Regional Medical Center, where offenders routinely receive care.

Less than two years before, Autumn Mason had a very different experience.

"Neither me nor my child were treated like human beings," recalled Mason, who is on work release after serving two years at Shakopee for criminal vehicular homicide. "I am just one of many women who had uncomfortable, incomplete and even some embarrassing, degrading experiences."

Mason, now 29, has become a driving force in a movement that has Minnesota officials rethinking how pregnant inmates should be treated. Her efforts helped overhaul state Department of Corrections guidelines to help make childbirth for inmates more closely mirror what women experience outside of prison.

Change had already begun with a 2014 anti-shackling law that went into effect two weeks after Mason delivered her daughter. It made Minnesota the 20th state to outlaw the use of restraints during and just after childbirth. It also became the first state to guarantee offenders access to birth coaches, called doulas.

More recent changes pushed by Mason and others ensure that expectant mothers receive parenting courses, additional food, and a breast pump to maintain milk production in cases where a new mother will be released soon enough to breast-feed at home.

Child welfare advocates say such steps are overdue in promoting healthy pregnancies and births, which save taxpayers money and build a foundation for babies who are innocent of their mother's crimes.

"Fundamentally, it benefits us all to have healthy children," said Rebecca Shlafer, a pediatrics professor at the University of Minnesota and a national expert on incarcerated mothers and their children. "This is about the earliest of investments in our community."

Shortly after giving birth to daughter Reality in 2014, Mason was shackled to the hospital bed and repeatedly told to send her newborn to the nursery, a request she rebuffed.

A long-standing prison policy barred her from pumping breast milk after returning to prison, so her breasts became painfully engorged. She stuffed her bra with sanitary napkins to soak up leaking milk.

Mason's struggles were not in vain. By the time her friend Icard was wheeled into that same unit two years later, she would be well-cared for, and sent back to Shakopee with a breast pump.

"It was as good as it gets for being in prison," said Icard, 30, who delivered her third child in May while serving eight months on drug charges.

Mason helped throw Icard a baby shower, a small gesture to cheer her up. Postpartum depression is seen more often in offenders, who must say goodbye to their infants after just 48 hours together.

A three-tiered "cake" built out of clean menstrual pads greeted Icard, stockpiled by women who knew she would need more than the prison provided for post-birth bleeding.

Tougher drug sentencing laws are largely responsible for a female prison population that has soared 700 percent nationwide between 1980 and 2014, increasing the likelihood of prison pregnancies.

Little reliable data are kept about the number of pregnant inmates and how prisons care for them. One in 25 women in state prisons nationwide reported being pregnant when admitted, according to the Bureau of Justice Statistics, which tracks national crime data. Shakopee did not systematically track that information before the Minnesota Prison Doula Project began operating at the prison in November 2010.

Eighteen doulas have assisted in delivering 94 babies for Shakopee inmates in the past six years, said program coordinator Rae Baker. Roughly 40 pregnant women enter Shakopee, the state's only women's facility, each year. About half of them deliver while incarcerated, Baker estimates.

The doula project also provides parenting classes and other services for expectant mothers at Shakopee and in county jails. Instruction prepares women for childbirth and provides hope that they can restore relationships with estranged children, Baker said.

"There's so much value to mothering," said Doula Project founder Erica Gerrity. "You can't put a dollar value on that."

Prison officials say the doulas are saving taxpayers money. Statistics show that pregnant inmates who use a birth coach are far less likely to need Caesarean sections, which cost roughly $15,000 each compared with $7,000 for a vaginal birth. Since the program began providing physical and emotional support to women in labor, the overall C-section rate has plunged from 63 to 27 percent.

The majority of offenders who give birth at St. Francis choose to breast-feed to establish a crucial bond that they hope will last until their release, the doulas said.

Before November 2015, inmates had no way of maintaining milk production. Pumps were not provided, and the facility did not allow for the storage or transport of breast milk to offenders' families — even at their own expense.

Kris Beuch, lactation consultant at St. Francis, fought to change those policies for more than a decade. She was haunted by the memory of a woman who desperately wanted to breast-feed and was denied a pump just two weeks before her release.

"Breast milk is the gold standard," Beuch said.

After breast-feeding her first two children, Mason was devastated to learn that her youngest would be deprived of her milk. It was another example of her baby being punished for her mistakes, she said.

Mason submitted an article to the prison newspaper lamenting the bans on breast-feeding and on loved ones in the delivery room. "These services would lift a tremendous amount of grief, depression and disconnect that we and our children experience," she wrote.

As a result, DOC administrators asked her to recount her experience — testimony later used at the State Capitol as evidence of the need to update departmental policies.

Meanwhile, Beuch made frequent calls to the prison inquiring about the possibility of providing pumps to women scheduled for release soon after their deliveries and was told, "It can't be done," she said. She hoarded pumps for when that finally changed.

When it did, Icard, with 42 days left in her sentence after delivering daughter Eniya, was one of the first inmates to take advantage. She pumped several times a day until her June 20 release. Each time, she had to discard the milk.

"I think I probably sat there in the bathroom and stared at my milk for at least 10 minutes before I could talk myself into dumping it out," she said.

Beuch offered to buy a mini-fridge to store the milk and to train officers on how to handle it, but prison officials declined.

Shakopee warden Tracy Beltz said changing such policies is not as simple as providing a refrigerator, citing concerns about space, time and staffing.

"There's that delicate balance between safety and security, and getting the offenders' needs met," she said.

After 40 years at St. Francis, Beuch said it's her goal to persuade the DOC that storage of breast milk "is a workable solution" before she retires.

Mason hopes to continue advocating for incarcerated mothers.

"We must allow these people to redeem themselves," she said. "I'm already stigmatized because of my record, and it's gonna follow me forever. But does that not entitle me to a decent quality of life if I choose to make different choices when I get out?"

As she re-connects with her children, Mason has thought about how she'll discuss her past with them. In her absence, they lived with their grandmother and were told she was away at college. The lie was meant to protect them from the backlash of her bad decisions, she said. But she compiled a scrapbook with letters from Shakopee and will share it with them in a few years.

"As a kid, you get a time out," Mason said. "As an adult, you get taken from your family."

Liz Sawyer • 612-673-4648